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General NPI Number Information
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NPI Number | 1831734136
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Entity Type | Individual
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Provider Name | EVA ASAMOAH FNP
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Gender | Female
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Dates
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Enumeration Date | 11/10/2019
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Last Update Date | 11/10/2019
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Provider Practice Location Address
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Address Line | 1787 MIDDLE COUNTRY RD # B
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City | CENTEREACH
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State | NY
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Zip | 11720-3507
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Country | US
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Telephone | 631-320-3053
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Fax |
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Provider Business Mailing Address
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Address Line | 129 BERKELEY AVE
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City | SELDEN
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State | NY
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Zip | 11784-1903
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Country | US
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Telephone | 631-459-0693
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F345213-01
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License Number State | NY
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